PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT No 4650
Date: .._:__►�_" �`_" . ,,"`""" _._ ______ ____. _
Owner: ....._. _. -° ..._.... Builder ....._.. ..............
...._....___..._... _..____..._ ._...___._.._ _...
Address d Address
L ION OF BUILDING
No. ..... _r.:.. street __............_ s _ _.....-_._ Part of Lo .___.._.._.. _._._.. _.._._. _..
,I t
Lot .....h........._........Block ....._:........... _.... Addition or Sub -Division ... .......... ....,..�:
t
Corner Lot .......................... ..... Inside Lot ..... _...... ``.............. Setback ...,_........ ............. Si eyard ....._............
............................. ......
SewerElevation....._......._...._............._............._...._._...._......._.___ _...._...... Foundation Elevation ....... .................... _.._......__._............. ................... ._.......
DESCRIPTION OF BUILDING
To Used as:
t
' ... :_ ...:xi:,�L....
Front
._.. Depth ... ..J._.6 Height .. �� _.. sq. Ft. amr/(' . Ft.
,
....r................ Front ..,-._.. Depth Height -w......... Sq. Ft. 7`... cu. Ft..,p1,
es
Type of Construction . _.:_,ter - # Q....... Est. I?rW..jr4.0......._........ To be Completed ....._......._...._ ............._.
THIS PERMIT DOES NO T AUTHORIZE VIOLAT-
ION OF ANY PRIVATE LAND COVENANTS AND
BUILDING RESTRICTIONS.
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the city of Fridley.
In consideration of thea y *'�""�
p yment of a fee of $.�,..�r..�..:..:.__....-, permit is hereby granted to --- _............._.....__---- -------- __----_--
to
-•to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limiiis and this permit may be revoked at any timgupon violation of any of the provisions of said
ordinances.`
,.-:` .__.. Building Inspector
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see
the Building Inspector for separate permits for these items.
4
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY; MINNESOTA
Owners Name Builder��
Address
LOCATION OF BUILDING
No. 616- Street 0' cjC".. _ Part of Lot
Lot �� Block q Addition or Sub.Div. &gja� _2)az4jL1
Corner Lot Inside Lot__V� Set Back Jj��Side-Yard &
SEWER ELEVATION FOUNDATION ELEVATION„9��„,_.%cL
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUILDING
To be used as:
Jront - Depth,_a.5, ;Ie l lHeight /.��
Sq. Ft.� a Cu. Ft. e,_
Front �,� ! Depth �--z Height 6'
Sq. Ft. ,�,i Cu. Ft.
Type of Construction_,, „� Estimated Cost //
To be
The undersigned hereby makes application for a permit for the work herein specified,
agreeing to do all work in strict accordance with the City Ordinances and ruling of
the Department of Buildings, and hereby declares that all the facts and representa-
tions stated in this application are true and correct. ,
DATE,SIGNATURE
(A Schedule of Fee costs can be found on the Reverse Side.)
City of Fridley
Appiicaifon fcw Pimnbing and Gas Fitting Pen*
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
21
O 4
ya
Z
€�
2�
y 1-
a�
Q Z
8�
Hi
o
�6
,
Z
z
90
R
N
WATER HTR.
GAS
ELEG
a
3f
o�
a
g�
i3
o°d
(9
(90
rMl3�
Bas
1st
2nd
3rd
4th
` Future Connection Openings
Connected with
New Fixture, Old Openings
I
Sewer
Cesspool 0
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE
Number Fixtures ...................... x $1.50
Future Fixture Opening ................ x 1.20
New Fixture Old Opening .............. x 1.00
Catch Basin ............................ x 3.25
Water Heater (Up to 200,000 BTU) ...... ® x 2.00
New Ground Run Old Bldg . ............ x 3.25
TOTAL
$ ZQ , 0
$
$
$ �.
$
GAS FITTING FEES: NO. RATE TOTAL
1st 3 Fixtures .......................... x $1.50
Additional Fixtures .................... x .50 $
Gas Range to 200,000 BTU .............. x 2.00 $
REPAIRS & ALTERATIONS—Refer to Code
DepL of Bldgs. Phone SII
IW
City of Fridley: q '
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City Ordinances
and ruling of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application are true and correct.
Fridley, • 194-0
Owner 19_
Kind of Building
Used as , - - e -
To be completed about 0
Estimated Cost, $
/11�
Ol —New. uilding Permit No '0 '6 7 2
Signe
By a
Business Phone No
JUN 8 1960
Description ................................................$
TOTAL FEE Q10.11 POST 1M-12-58
19_
(REMARKS—OVER)
Application for Power Plants and Heating.
Cong. Ventilation, .ReFi igeration and
Air Conditioningdi
Systems and Devices
PARTIAL RATE SCHEDULE
Dept. of Bldgs. Phone SII, 4-7470
GRAVITY WARM AIR:
RATE
TOTAL,
Loca3ton &kkze.
Furnace Shell & Duct Work ..........................
8.00
$
Replacement of Furnace .............................
5.00
$
City of Fridley:
Repairs & Alterations—up to $500.00 ..................
5.00
$
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City Ordinances
Repairs & Alterations each add. $500.00"
2.50
$
and ruling of the Department of Buildings, and hereby declares that all the facts
" " " " "
" '
and representations stated in this application are true and correct.
MECIL WARM 'AIR
Fridley, Minn 19
Furnace Shell & Duct Work to 120,000 BTU ............
8.00
$
each add. 60,000 BTU .... . ..
2.00
$ –
Owner
xReplacement of Furnace .............................
0.00
$
Kind of Building
Repairs & Alterations—up to $500.00 ...:.............
5.00
$
Repairs & Alterations each add. $500.00 ...... I .$
... 2.50
Used as gp �
47
STEAM or HOT WATER SYSTEM
To be completed about r1
Furnace Shell & Lines—to 400 sq. ft. EDR Steam.......
8.00
$
Estimated Cost, $ 0
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water
... 8.00$
/ / •'
Old—New. Building Permit No. �� Permit No.
Each add. 200 sq. ft. EDR Steam ......................
2.50
$
Each add. 320 sq. ft. EDR Hot Water ..................
2.50
$
DESCRIPTION OF WORE
OIL BURNER—to 3 gal. per hour ........................
5.00
$
HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No
over 3 gal. per hour—See Fee Schedule
®
P
Trade Name '&x/ � z_a ►%1�--- Size No
GAS BURNER (u to 400 000 BTU)
p.......................
5.00
$
Capacity Sq. Ft. E.D.R ® BTU H.P.
GAS FITTING FEES:
NO RATE TOTAL
1st 3 Fixtures ......................
x $1.50
$ 4.4-0
Total Connected Load' Kind of Fuel
Additional Fixtures .................
x .50
$
BURNER —Trade Name Size No
Gas Range to 200,000 BTU ...........
x 2.00
$
Capacity Sq. Ft. E.D.R BTU H.P.
AIR CONDITIONING
$
FAN HEATING SYSTEM See Fee Schedule
VENTILATING SYSTEM
$
ALTERATIONS & REPAIRS TOTAL FEE
®
Sign
By.
ROUGH
48 2M 7.59 Business Phone No
FINAL
(REMARKS—OVER)
Infiltration I ® 6
Glass -<0 O D
Exp. wall
Net exp. wall /O J, O
Int. wall
1-v.;PA 1 0� 1 a 2d A
Ceil.or floor
Total Btu.
3�
O
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
HEAT LOSS CALCULATIONS
DEPARTMENT OF I01UILDINGS
MINNEAPOLIS, MINN.
Weatherstrips
A•S.H.V:E.
/8 1 Coef.
Construction No.
Infiltration
Insulation
Coef.
Guide
Infiltration
p
Exp. wall/.O
Glass
Uro
Windows
Doors
Reference
Out. Wall I
Int. Wall
I Ceiling 1__!Ioof
I Floor
Kind
I How Applied
Yes—No
Yes-
I -No
19
e2
Q o
Width Height No of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
/ Fl.W11 Room I Length Zj! Width /Q- Height & e
Btu
/ Flle--4 y
Room -1 Length/4a Width //2 Height 9'3
Win ows and Doors—Crackage and Area
A3
®
Windows and
Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Net. exp. wall
Width
No. of pane
Height No. of Lineal ft. Area
ofane lights of crack sq. ft.
P.
Int. wall
a�
.��Lev
8'00
Ceil. or floor �®
S
Total Btu.
Coef. Btu
S4„g'
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Coef. i Btu
Infiltration I ® 6
Glass -<0 O D
Exp. wall
Net exp. wall /O J, O
Int. wall
1-v.;PA 1 0� 1 a 2d A
Ceil.or floor
Total Btu.
3�
O
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Btu
Room I Length'./—
Width Height &s
Windows and Doors—Crackage and Area J:7
Width Height No. of Lineal ft. Area —
No. of pane of=lights of crack sq. ft* — f
Z a3 9
/S6
/8 1 Coef.
Btu
Infiltration
¢Q
Coef.
Glass
Infiltration
p
Exp. wall/.O
Glass
Uro
Net exp. wall
Windows and Doors--Crackage and Area
No. IWidth I Height No. of Lineal ft. Area
of pane of parte lights of crack sq. fe.
Int. wall
/6® -5-
SCeil.
Total Btu.
Ceil.or floor
�� S
/ F1. Lnov Room I Length/e.1 Width d' - Height g
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
e2
Q o
Width Height No of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
��J��""fes 7-.�.T.l .-.1�R3-.T.3 i.7/�. -•.•l T.fi.7//rte=►lT.'IZS t+s
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
Btu
Infiltration S®
No. of pane of pane lights of crack sq. ft.
/®
/S6
Int. wall
Exp. wall 7/4
Coef.
Btu
Infiltration
11,461
ale p
Glass
Uro
® O
Net exp. wall 6,0 O A�
Int. wall
/ s /® ,0 ro
Ceil., or floor / a
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
D-56
If". Pt's Co„ Prtutar;
Glass
Exp. wall IV 6
Btu
Infiltration S®
Net exp. wall
/®
/S6
Int. wall
Exp. wall 7/4
Net exp. wall 11741
Ceil. or floor
Total Btu.
11,461
S®
Required sq. ft. E.D.R. or. sq. ins. W.A. Leader area
/ F1.I 6k® e Room I Length /3 - Width//-' Height k=
Windows and Doors--Crackage and Area
No. IWidth I Height No. of Lineal ft. Area
of pane of parte lights of crack sq. fe.
Ceil. or floor /
Coef.
Btu
Infiltration S®
® O
Glass -90
Exp. wall 7/4
Net exp. wall 11741
11,49
11,461
Int. wall
Ceil. or floor /
Total Btu.
Required sq. ft. E.D.R. or sq. ins.W.A. Leader area
/ F1. Lnov Room I Length/e.1 Width d' - Height g
Windows and Doors--Crackage and Area
e2
Q o
Width Height No of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Coef.
Btu
Infiltration
®
O
Glass
®
��
Exp. wall
Net. exp. wall
® ,
Int. wall
.��Lev
8'00
Ceil. or floor �®
S
Total Btu.
S4„g'
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
l�
suB�Ecr
PER
City of Fridley
-
AT THE TOP OF THE TWINS
BUILDING PERMIT
.15760
f
RECEIPT NO.
• COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
1 �
i ��""1,•� CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
---.�
612-571-3450
910-F15
6/5/80
JOB ADDRESS 65 - 66th Way N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
16
4
Edgewater Gardens SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Remy Bourne 65 - 66th Way N.E. 574-7412
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Day's Remodeling 2701 County Road H Minneapolis, MN 55432 786-2820
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
Remodel basement bathroom
9 CHANGE OF USE FROM TO
STIPULATIONS
Provide power vent. Provide fire alarm. Use treated bottom plates.
Any styrofoam must be covered with 12 gypsum board
SEPERATE PERMITS REQUIRED FOR MMme,
"EATING, Pc UM81NG AND SIM.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SQ. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$3,000
$1.50
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$18.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
19.50
ONTRACTORO RIZEDAGENT IDATEI
SI Tu�F�'NER
WHEN PROPER Y VALIDATED THIS IS YOUR PERMIT
BLDG INSP E
S NAT E IIF OWNER L RI IDATEI
l�
CITY OF FRIDLEY
APPLICATION FOR RESIDLNTIAI_ BUILDING PERMITS
(New, Alterations, Additions, or Repairs)
OWNER:PemX,,,f 6rs
ADDRESS
TEL NO:,�_7 '(—
BUILDER: ,0a�/`s ��Ukc►de I I I�l�i
ADDRESS: 2:20 co
�Is3z'
TEL NO:
Construction Location
STREET NO: 65 STREET:
LOT:. -BLOCK: ADDITION:
Corner Lot: Inside Lot: j�_ Setback: Sideyards:
Applicant attach ;:o this form two Certificates of Survey of lot and
proposed building location drawn on certificates to.scale.
DESCRIPTION OF CONSTRUCTION
Front: Depth: H eight :
Square. Feet_ Cubic Feet:
Front: Depth: Height:
Square - Feet: Cubic Feet:
art
Type of Construction. 0��1 1� J 1 +t Estimated Cost: $ Dr® d
:.� arlm� c era�vw- �l�su fairy c�G(r C-`vr
lb Be Completed: 4
• Alt. A Alt. II
Proposed Driveway Width If New Opening Is Desired: $ $ „
SEE REVERSE SIDE OF SHEET .
The undersigned hereby makes application for a permit for the work herein specified,
agreeing to do all work in strict accordance with the City of Fridley Ordinances and
rulings of the Department of Buildings, and hereby declares that all the facts and
representations stated in this applicatly!)n ire true,_q�d correct.
DATE 6 r Z __*_L S IGNATU PE :
Stipulations: �� ��
SUBJECT
PE
City of Fridley
AT THE TOP OF THE TWINS
BUILDING
PERMIT
2 8 3 5 0
r
1
COMMUNITY DEVELOPMENT DIV.
91.7
__��__
r PROTECTIVE INSPECTION SEC.
e
6 (�
l
NUMBER
REV
DATE
PAGE OF
AVPROVEO Br
i ��"' �.� CITY HALL FRIDLEY 55432
.--.�
L 612-571-3450
910-F15
110/21/98
10B ADDRESS 65 66th Way NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DEscR.
16
4
I Edgewater Gardens
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Dale Sol--
574-747
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE
LICENSE NO
Am. Roofing & Const. Inc. 23624 St Francis Blvd St Francis
55070753-745L
20109395
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE
LICENSE NO
5 ENGINEER MAIL ADDRESS
ZIP PHONE
LICENSE NO
6 USE OF BUILDING
Residential
I CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION Jk REPAIR ❑ MOVE
❑ REMOVE
B DESCRIBE WORK
Reroof house and garage (30 Sq) Tear -off
B CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT
CU FT.
AUTHORIZED IS NOT COMMENCED WITHIN W DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR N THE GRANTING OF A PERMIT
$2571
$1.29
DOES NOT PRESUME TO GIVE AUT ITV O VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER ST E OR AL LAW REGULATING CON-
STRUCTION R TH ERFORM CE C
$74.75
Fire SC $2.57
PLAN CHECK FEET
AL FEE
Licens
83.61
SIGNATURE OF ONTRACTOR OR AUTHORIZED AGENT (DATE.
HEN R
D INSO
V LID THIS IS YOUR P RM
MATE
SIGNATURE OF OWNERI.f OWNER BUILDER. IDATEI
NEW [ ]
ADDN [ ]
ALTER [ ]
ConstructionAddress:
Legal Description:
Owner Nam
Contractor:
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Effective 1/1/98
A 13,56, 1
Tel. # S-7 `( %
TENSE #
Address: (e '� S _ iL Tel. #i%��� 7 �
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
Construction Type:
® ' Estimated Cost: $J �� z9b
(Fee ed a on Back)
7Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft $ _ $
DATE: LL(S {IAPPLICANT:
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
Tel. # 7-�
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1000 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ J
\91j 4
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
572-3604
Stories
Basement
Floor 1
Floor 2
Floor 3
Floor 4
i =�L
PLUMBING FIXTURE RATES
Effective On January 1, 1999
Gas Mise;:;i: Water Heater
Range 1Fixt`*::.';° Gas Elec
NO.W�E b
RATE TOTAL JOB ADDRESS � k)
New Fixtures
$ 7.00�V
Old Opening, New Fixture
$ 4.00
Beer Dispenser
$ 5.00
Blow Off Basin
$ 7.00
Catch Basin
$ 7.00
Rain Water Leader
_ $ 7.00
Sump/Receiving Tank
$ 7,00
Water Treating Appliance
$10.00
Water Heater —Electric
$ 7.00
Water Heater — Gas**
$10.00
Gas Range"
$10.00
Gas Dryer**
$16.00
Back Flow Preventer Required ( )Yes ( ) No
Type $15.00
Reinspection Fee $42.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance p
The undersigned hereby makes application for a perm it for the work herein
specified agreeing to do all work in strict accordance with the city codes
and rulings of the Building Division, and hereby declares that all the facts
and representations stated in this application are true and correct.
31 OS , 1999
n .,
Owner
Building Used As - r)L� _UAk&
Estimated Cost PERMIT NO.
WGU1RE & SONS
PLUMBING COMPANY 6n512th Avenue South
Hopkins, MN 55343 f
SIGNED BY , TEL N0.
Approved By Rough—In Date Final Date r/(
State Surcharge $ 50
�1 MINIMUM FEE 'FOR ANY PLUMBING GAS PERMIT IS $20.00
TOTAL FEE PLUS THE $.50 STATE SURCHARGE
"COMBUSTION AIR SHALL BE PROVIDE ECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SQ INCHES.
SUBJECT
City of Fridley
33599
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
r I �
1 . i
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
763-571-3450
910-F15
6/10/03
JOB ADDRESS 65 66 Way NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
16
4
Edgewater
Gardens
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Dale Solberg 65 66 Way NE
763-574-7412
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
K -Designers 3810 West Hwy 13, BMSVILLE MN 55337 952-894-3600
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION Ck REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Soffit & Fascia
9 CHANGE OF USE FROM
TO
STIPULATIONS
Install soffit ventilation to
meet the State Building Code.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT
CU FT
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED
NO DWLG, UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. TME GRANTING OF A PERMIT
$7,133
$3.56
DOES NOT PRESUME TO GIVE AUTHORIT T VIOLATE OR CANCEL THE
PERMIT FEE
SACCHARGE
PROVISIONS OF ANY OTHER TATE OR O L LAW REGULATING CON•
$153.25
Fire SC $7.09
STRUCr1O THE PERFOR OF ON TRUCTION
22
®J
PLAN CHECK FEE
TOTAL EE
&-to-
License
5.
$ 68.90
SIGNATURE OF CONTRACT b R Op UTHORfZ GENT ATE)
N P OPE LIDATE T IS I44�- RMIT
D INS
At If
S,GNATU RE OF OWNE R, IF OWNER BUILDER) (DATE)
JUN -04-2003 14:57 FROM CITY OF FRIDLEY TO 9528940900 P.02i05
NEW j ] CITY OF FRIDLEY
ADDN j JEffective 1/112003
643) University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
i 111'5T'r BUILDING PERMIT APPLICATION
Construction Address: 65
Legal Description:
Owner Name & Address: .,i � � Tel. # 5 7
Contractor. MN LICENSE# fid/ 3c� ARS _
Address: I / Tel. # -2? r'y v:�(Zn
Attach to this application, a certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height_ Sq. Ft.
GARAGE AREA: Length _ Width Height . Sq. Ft.
DECK AREA: Length Width HgVGround _ sq. Ft.
OTHER:
Construction Type�T-��r
Estimated Cost: $ ! %%33
�
Driveway Curb C
utth Needed: Ft. + 6 !=t = Ft x $ _ $`�
DATE: �/ APPLICANT:
Tel. #
Call (763) 572-3604 for Permit Fees if mailing in application.
call you for card number. to 763-571-1287 if using credit card and we will
i" CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
$ Fee Schedule on Reverse Side
$ .001 of Permit Valuation (1/10th%)
$ $.50/$1,000 Valuation
$ —� $1275 per SAC Unit
$ $5.00 (State Licensed Residential Contractors)
$ Alt. "A" or Alt. "6" Above
$ $450.00 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement Necessary[ ] Not Necessary[ ]
$ 168.
u
SUBJECT
PERMIT NO.
City of Fridley
403
?-,AT THE TOP OF THE TWINS
BUILDING
P E R M I T
r
RECEIPT NO.
rr
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.01
I
1
NUMBER
REV
DATE
PAGE OF
APPROVED 8r
I i 1 CITY HALL FRIDLEY 55432
763-571-3450
910-F15
11/20/03
JOB ADDRESS 65 66 Way NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
16
4
1 Edgewater Gardens SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Dale Solberg 65 66 Way NE
763-574-7412
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Custom Remodelers Inc 474 Apollo Dr, Lino Lakes MN 55014 651-784-2646 1748
d ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION D REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
Replace 7 windows within existing openings
9 CHANGEOFUSEFROM
TO
STIPULATIONS
Provide smoke detectors in all sleeping rooms and on all levels of the dwelling
per Section 310.9.1.2 of the 1997 Uniform
Building Code. Caulk and flash all
exterior openings.
Permit Inspection Cards
Will Be Mailed
To Homeowner To Post
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL. PLUMBING, HEATING.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
VENTILATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT
CU FT
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$2,495
$1.25
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING COW
$83.25
Fire SC $2.49
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
TOTALFEE
ce a SC $5.00
$91.99
SIGNATURE OF CON"RACTOR OR AUTHORIZED AGENT iDATE,
/VV'HEN PROPERLY VALIDATED THIS IS YUR PER IT
U j� A V L-3
fiLD INS MATE
S-GNATURE OF OWNER,IT OWNER BUILDER, 'DATES
u
NEW
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: ti� -1 � C() (W
Legal Description:
Owner Name & Address:
Contractor:
Address:
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Effective 1/1/99
Tel. # M -511f- 7q 10
MN LICENSE # 174
el. # Kf — 7 �rLf —U 4�
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
G P
Construction Type: Estimated Cost: $
(Fee Schedule'. on Back)
Driveway Curb Cut Width Needed:.. Ft. + 6 Ft = Ff x
DATE: (� 0 o
APPLICANT ' Tel. #615(4 3 L[ f k
CITY USE ONLY
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
$ 6" ®n
Park Fee $
Sewer Main Charge $
TOTAL
STIPULATIONS:
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.501$1,000 'Valuation
$1050 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreemeut"Necessary [ ] Not Necessary [ ]